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Essential amino acids in the gluten-free diet and serum in relation to depression in patients with celiac disease.

van Hees NJ, Giltay EJ, Tielemans SM, Geleijnse JM, Puvill T, Janssen N, van der Does W - PLoS ONE (2015)

Bottom Line: The intake of vegetable protein was significantly lower in CD patients than in healthy controls (mean difference of 7.8 g/d; 95% CI: 4.7-10.8), as were serum concentrations of tyrosine, phenylalanine and tryptophan (all p < 0.005).However, within the CD patient group, the presence of major depressive disorder (n = 42) was not associated with intake or serum levels of essential amino acids.Despite its potential adverse effect, intake and serum levels of essential amino acids were not related to major depression.

View Article: PubMed Central - PubMed

Affiliation: Institute of Psychology, Leiden University, Leiden, The Netherlands.

ABSTRACT

Introduction: Celiac disease (CD) is associated with an increased risk of major depressive disorder, possibly due to deficiencies in micronutrients in the gluten-free diet. We aimed to investigate whether essential amino acids (i.e., the precursors of serotonin, dopamine and other neurotransmitters) are depleted in the diet and serum of CD patients with major depressive disorder.

Methods: In a cross-sectional study we assessed dietary intake of amino acids and serum levels of amino acids, in 77 CD patients on a gluten-free diet and in 33 healthy controls. Major depressive disorder was assessed with structured interviews (using the Mini International Neuropsychiatric Interview Plus). Dietary intake was assessed using a 203-item food frequency questionnaire.

Results: Participants had a mean age of 55 years and 74% were women. The intake of vegetable protein was significantly lower in CD patients than in healthy controls (mean difference of 7.8 g/d; 95% CI: 4.7-10.8), as were serum concentrations of tyrosine, phenylalanine and tryptophan (all p < 0.005). However, within the CD patient group, the presence of major depressive disorder (n = 42) was not associated with intake or serum levels of essential amino acids.

Conclusions: Patients with CD on a long-term gluten-free diet, with good adherence, consume significantly less vegetable protein than controls, and their serum levels of several essential amino acids were also lower. Despite its potential adverse effect, intake and serum levels of essential amino acids were not related to major depression.

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Flow chart of participants in the study.
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pone.0122619.g002: Flow chart of participants in the study.

Mentions: CD patients were recruited from participants in a previous Dutch survey study [9] who gave permission to be contacted (Fig 2). They were selected on the criterion of maintaining a strict gluten-free diet for 2 years or more. In order to obtain equal group sizes, participants who had expressed the presence of depressive symptoms, were oversampled to form the major depressive disorder group of CD patients. Never-depressed controls without CD were recruited from a general population sample and matched for age, gender and level of education. These participants were recruited through general practitioners, and had been willing to participate in a previous study as a control group to assess normal values for psychiatric scales [27]. A total of 127 participants entered the study (85 CD patients and 42 controls). A more detailed explanation of the recruitment procedure, the study procedures and the measurement instruments has been described elsewhere [10]. Confirmation of CD diagnosis was obtained from medical records for all but 8 (11.2%) participants. The exclusion criteria for all participants in the current study were: age younger than 18, having an inflammatory bowel disease other than CD, or having conditions which would make the testing session unreliable or impossible. CD participants were also excluded if they had low adherence to the gluten-free diet or were on the diet for less than 2 years. Healthy controls where excluded if they had any mood disorder diagnosis, had coeliac disease or were on a gluten-free diet. Seventeen participants were excluded on one or more of the following criteria, resulting in a final sample size of 110 (Fig 1): bipolar disorder (n = 3), current alcohol abuse (n = 2), current drug abuse (n = 1), not fasting on morning of testing (n = 2), healthy control with lifetime diagnosis on Mini International Neuropsychiatric Interview of any mood disorder (n = 6), and the use of Trp dietary supplements (n = 3).


Essential amino acids in the gluten-free diet and serum in relation to depression in patients with celiac disease.

van Hees NJ, Giltay EJ, Tielemans SM, Geleijnse JM, Puvill T, Janssen N, van der Does W - PLoS ONE (2015)

Flow chart of participants in the study.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4401736&req=5

pone.0122619.g002: Flow chart of participants in the study.
Mentions: CD patients were recruited from participants in a previous Dutch survey study [9] who gave permission to be contacted (Fig 2). They were selected on the criterion of maintaining a strict gluten-free diet for 2 years or more. In order to obtain equal group sizes, participants who had expressed the presence of depressive symptoms, were oversampled to form the major depressive disorder group of CD patients. Never-depressed controls without CD were recruited from a general population sample and matched for age, gender and level of education. These participants were recruited through general practitioners, and had been willing to participate in a previous study as a control group to assess normal values for psychiatric scales [27]. A total of 127 participants entered the study (85 CD patients and 42 controls). A more detailed explanation of the recruitment procedure, the study procedures and the measurement instruments has been described elsewhere [10]. Confirmation of CD diagnosis was obtained from medical records for all but 8 (11.2%) participants. The exclusion criteria for all participants in the current study were: age younger than 18, having an inflammatory bowel disease other than CD, or having conditions which would make the testing session unreliable or impossible. CD participants were also excluded if they had low adherence to the gluten-free diet or were on the diet for less than 2 years. Healthy controls where excluded if they had any mood disorder diagnosis, had coeliac disease or were on a gluten-free diet. Seventeen participants were excluded on one or more of the following criteria, resulting in a final sample size of 110 (Fig 1): bipolar disorder (n = 3), current alcohol abuse (n = 2), current drug abuse (n = 1), not fasting on morning of testing (n = 2), healthy control with lifetime diagnosis on Mini International Neuropsychiatric Interview of any mood disorder (n = 6), and the use of Trp dietary supplements (n = 3).

Bottom Line: The intake of vegetable protein was significantly lower in CD patients than in healthy controls (mean difference of 7.8 g/d; 95% CI: 4.7-10.8), as were serum concentrations of tyrosine, phenylalanine and tryptophan (all p < 0.005).However, within the CD patient group, the presence of major depressive disorder (n = 42) was not associated with intake or serum levels of essential amino acids.Despite its potential adverse effect, intake and serum levels of essential amino acids were not related to major depression.

View Article: PubMed Central - PubMed

Affiliation: Institute of Psychology, Leiden University, Leiden, The Netherlands.

ABSTRACT

Introduction: Celiac disease (CD) is associated with an increased risk of major depressive disorder, possibly due to deficiencies in micronutrients in the gluten-free diet. We aimed to investigate whether essential amino acids (i.e., the precursors of serotonin, dopamine and other neurotransmitters) are depleted in the diet and serum of CD patients with major depressive disorder.

Methods: In a cross-sectional study we assessed dietary intake of amino acids and serum levels of amino acids, in 77 CD patients on a gluten-free diet and in 33 healthy controls. Major depressive disorder was assessed with structured interviews (using the Mini International Neuropsychiatric Interview Plus). Dietary intake was assessed using a 203-item food frequency questionnaire.

Results: Participants had a mean age of 55 years and 74% were women. The intake of vegetable protein was significantly lower in CD patients than in healthy controls (mean difference of 7.8 g/d; 95% CI: 4.7-10.8), as were serum concentrations of tyrosine, phenylalanine and tryptophan (all p < 0.005). However, within the CD patient group, the presence of major depressive disorder (n = 42) was not associated with intake or serum levels of essential amino acids.

Conclusions: Patients with CD on a long-term gluten-free diet, with good adherence, consume significantly less vegetable protein than controls, and their serum levels of several essential amino acids were also lower. Despite its potential adverse effect, intake and serum levels of essential amino acids were not related to major depression.

Show MeSH
Related in: MedlinePlus